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1.
Arq. bras. cardiol ; Arq. bras. cardiol;121(5): e20230678, 2024. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1557054

ABSTRACT

Resumo Fundamento Estudos prévios têm sido inconsistentes em demonstrar efeitos cardiovasculares benéficos da suplementação de vitamina D. Objetivo Avaliar efeitos da suplementação de vitamina D3 sobre parâmetros hemodinâmicos centrais e atividade autonômica em indivíduos obesos/sobrepeso e baixos níveis de vitamina D (<30ng/dl). Métodos Ensaio clínico prospectivo, randomizado, duplo-cego (NCT 05689632), adultos 40-65 anos com índice de massa corporal ≥25<40 kg/m2. Hemodinâmica central avaliada por método oscilométrico (Mobil-O-Graph®), variabilidade da frequência cardíaca utilizando frequencímetro Polar (software Kubios®). Os pacientes (n=53) receberam placebo no grupo controle (CO, n=25) ou vitamina D3 (VD, n=28) 7000 UI/dia, avaliados antes (S0) e após 8 semanas (S8) com nível de significância de 0,05. Resultados Os grupos foram homogêneos na idade (51±6 vs. 52±6 anos, p=0,509) e níveis de vitamina D (22,8±4,9 vs. 21,7±4,5ng/ml, p=0,590). Na S8, o grupo VD apresentou níveis significativamente maiores de vitamina D (22,5 vs. 35,6ng/ml, p<0,001). Apenas o grupo VD mostrou redução significativa da pressão arterial sistólica (PAS; 123±15 vs. 119±14mmHg, p=0,019) e fosfatase alcalina (213±55 vs. 202±55mg/dl, p=0,012). O grupo CO mostrou elevação da pressão de aumento (AP: 9 vs. 12mmHg, p=0,028) e do índice de incremento (Aix: 26 vs. 35%, p=0,020), o que não foi observado no grupo VD (AP: 8 vs. 8mmHg, Aix: 26 vs. 25%, p>0,05). Grupo VD apresentou aumento no índice do sistema nervoso (iSN) parassimpático (-0,64±0,94 vs. -0,16±1,10, p=0,028) e no intervalo R-R (866±138 vs. 924±161ms, p=0,026). Conclusão Nesta amostra, a suplementação diária de vitamina D durante oito semanas resultou em melhora dos níveis pressóricos, parâmetros hemodinâmicos centrais e do equilíbrio autonômico.


Abstract Background Previous studies have been inconsistent in demonstrating beneficial cardiovascular effects of vitamin D supplementation. Objective To evaluate the effects of vitamin D3 supplementation on central hemodynamic parameters and autonomic activity in obese/overweight individuals with low vitamin D levels (<30ng/dl). Methods Adults 40-65 years old with body mass index ≥25<40 kg/m2 were enrolled in this prospective, randomized, double-blind clinical trial (NCT 05689632). Central hemodynamics was assessed using the oscillometric method (Mobil-O-Graph®), and heart rate variability using a Polar heart rate monitor (Kubios® software). Patients (n=53) received a placebo in the control group (CO, n=25) or vitamin D3 (VD, n=28) 7000 IU/day, and were evaluated before (W0) and after 8 weeks (W8) with a significance level of 0.05. Results The groups were homogeneous regarding age (51±6 vs 52±6 years, p=0.509) and vitamin D levels (22.8±4.9 vs 21.7±4.5ng/ml, p=0.590). At W8, the VD group had significantly higher levels of vitamin D (22.5 vs 35.6ng/ml, p<0.001). Only the VD group showed a significant reduction in systolic blood pressure (SBP; 123±15 vs 119±14mmHg, p=0.019) and alkaline phosphatase (213±55 vs 202±55mg/dl, p=0.012). The CO group showed an increase in augmentation pressure (AP: 9 vs 12 mmHg, p=0.028) and augmentation index (AIx: 26 vs 35%, p=0.020), which was not observed in the VD group (AP: 8 vs 8 mmHg, AIx: 26 vs 25%, p>0.05). VD group showed an increase in the parasympathetic nervous system index (PNSi) (-0.64±0.94 vs -0.16±1.10, p=0.028) and the R-R interval (866±138 vs 924±161 ms, p= 0.026). Conclusion In this sample, eight weeks of daily vitamin D supplementation resulted in an improvement in blood pressure levels and autonomic balance.

2.
Rev. méd. Minas Gerais ; 33: e-33201, Jan.-Dez. 2023.
Article in English, Portuguese | LILACS | ID: biblio-1551496

ABSTRACT

INTRODUÇÃO: A deficiência de Vitamina D (VD) é frequente na doença falciforme (DF) em decorrência do status inflamatório crônico, danos renais, endoteliais, hiperhemólise e melanodermia. Atualmente, a suplementação desse nutriente em falcêmicos tem se mostrado importante devido sua ação sistêmica e imunológica. OBJETIVOS: Analisar o impacto da VD em crianças com DF. MÉTODOS: Trata-se de uma revisão integrativa da literatura, onde foram analisados estudos, publicados originalmente em inglês e português, dos últimos dez anos, em humanos, tendo como referência as bases de dados MEDLINE, SciELO e LILACS. A busca foi efetuada mediante a consulta ao MeSH. Os descritores utilizados foram: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". Foram identificados 32 artigos a partir da frase de pesquisa. Ao aplicar os critérios de inclusão, nove artigos foram eleitos para o estudo. RESULTADOS: A partir da análise dos artigos incluídos, 6 avaliaram a prevalência da deficiência de VD em crianças com anemia falciforme e os outros três artigos relataram sobre a suplementação de VD em crianças também com anemia falciforme. Todos os estudos mostraram que as crianças tratadas com reposição de VD tiveram uma diminuição de idas ao pronto-socorro e maior estabilidade hemodinâmica durante os tratamentos. CONCLUSÃO: Outros ensaios clínicos randomizados devem ser realizados para identificar o papel da DV na qualidade de vida e na redução da morbidade falciforme. A contribuição deste artigo é reconhecer que há evidências sobre a vitamina D fora dos ensaios clínicos randomizados.


INTRODUCTION: Vitamin D (VD) deficiency is frequent in sickle cell disease (SCD) due to chronic inflammatory status, kidney and endothelial damage, hyperhemolysis and melanoderma. Currently, the supplementation of this nutrient in sickle cell patients is important due to its systemic and immunological action. Objectives: To analyze the impact of VD in children with SCD. METHODS: This is an integrative literature review, which analyzed studies, originally published in English and Portuguese, in the last ten years, in humans, using the MedLine, SciELO and LILACS databases as References. The search was performed by consulting the MeSH. The descriptors used were: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". 32 articles were identified from the search phrase. When applying the inclusion criteria, nine articles were chosen for the study. RESULTS: Among the included articles, six evaluated the prevalence of VD deficiency in children with sickle cell anemia, and the other three reported on VD supplementation in children with sickle cell anemia. All studies showed that children treated with VD replacement had a decrease in emergency room visits and greater hemodynamic stability during treatments. CONCLUSION: Further randomized controlled trials should be carried out to identify the role of VD in quality of life and in the reduction of sickle cell morbidity. The contribution of this paper is to recognize that there is evidence about vitamin D outside of randomized controlled trials.


Subject(s)
Humans , Child , Adolescent , Vitamin D Deficiency , Dietary Supplements , Anemia, Sickle Cell/complications
3.
Rev. Fac. Med. Hum ; 23(4): 129-141, oct.-dic. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1559082

ABSTRACT

RESUMEN La psoriasis es una enfermedad crónica de la piel mediada por el sistema inmunológico con una base genética y patogénica compleja, que frecuentemente conduce a comorbilidades significativas y una reducción en la calidad de vida. Su prevalencia varía a nivel global y muestra una tendencia creciente con el tiempo. Comorbilidades como la artritis psoriásica, enfermedades cardiovasculares y problemas de salud mental complican aún más la carga de la psoriasis. Las opciones de tratamiento van desde terapias tópicas hasta agentes sistémicos, siendo los agentes biológicos prominentes en los últimos años. Sin embargo, la seguridad y eficacia de estos tratamientos se evalúan continuamente a través de datos del mundo real. La vitamina D ha llamado la atención como un posible objetivo terapéutico debido a su papel en la regulación inmunológica y la función de barrera de la piel. Esta revisión tiene como objetivo evaluar la eficacia de la suplementación oral de vitamina D en mejorar la gravedad de la psoriasis. Después de una búsqueda bibliográfica, se encontró que la psoriasis es una condición multifacética con significativas implicaciones globales. Los agentes biológicos han transformado su manejo, y la suplementación oral de vitamina D es un camino prometedor para una mayor exploración. Un enfoque integral centrado en el paciente que tenga en cuenta las comorbilidades y los resultados a largo plazo es crucial para optimizar el cuidado de la psoriasis. Se necesita más investigación para comprender completamente el papel de la vitamina D en la psoriasis y su potencial como intervención terapéutica.


ABSTRACT Psoriasis is a chronic immune-mediated skin disease with a complex genetic and pathogenic basis, often leading to significant comorbidities and a reduced quality of life. Its prevalence varies globally and exhibits an increasing trend over time. Comorbidities such as psoriatic arthritis, cardiovascular diseases, and mental health issues further compound the burden of psoriasis. Treatment options range from topical therapies to systemic agents, with biologics playing a prominent role in recent years. However, the safety and efficacy of these treatments are continuously assessed through real-world data. Vitamin D has gained attention as a potential therapeutic target due to its role in immune regulation and skin barrier function. This review aims to evaluate the efficacy of oral vitamin D supplementation in ameliorating the severity of psoriasis. After bibliographic search, it was found that psoriasis is a multifaceted condition with significant global implications. Biologics have transformed its management, and oral vitamin D supplementation is a promising avenue for further exploration. A comprehensive, patient-centered approach that considers comorbidities and long-term outcomes is crucial for optimizing psoriasis care. Further research is needed to fully understand the role of vitamin D in psoriasis and its potential as a therapeutic intervention.

4.
Actual. nutr ; 24(3): 205-214, Jul-Sept 2023. tab
Article in Spanish | LILACS, ARGMSAL, BINACIS | ID: biblio-1511570

ABSTRACT

Introducción: El déficit de vitamina D y la diabetes son dos situaciones prevalentes en todas las edades, regiones geográficas y niveles socioeconómicos. La presencia de receptores para 1,25(OH)2D y la existencia de la enzima 1-α-hidroxilasa en la célula beta ­que permite la síntesis del metabolito activo­ sugieren que la vitamina D juega un papel importante en dichas células y que su deficiencia podría ser un factor capaz de acelerar el inicio y la evolución de la enfermedad. Objetivos: Se realizó una revisión del tema vitamina D y Diabetes. A su vez, se analizó el rol de la vitamina D en la insulinorresistencia y en la DM2, así como en la autoinmunidad y la DM1. También se indagó en el estado actual sobre los efectos de la suplementación con vitamina D en la prevención, el control glucémico y la evolución de las complicaciones asociadas a esta enfermedad. Materiales y Métodos: Se realizó una búsqueda bibliográfica utilizando los buscadores PubMed, MEDLINE, Cochrane, Research Gate. Los criterios de búsqueda fueron "vitamin D", "vitamin D and diabetes", "vitamin D and supplementation". Conclusiones: Existe suficiente evidencia acerca de que los niveles séricos de 25(OH)D deberían alcanzar valores entre 30 y 50 ng/ml para influir en las funciones metabólicas. Se enfatiza en la importancia de incluir el dosaje de 25(OH)D en el control clínico de rutina. Teniendo en cuenta la escasa distribución de la vitamina D en los alimentos naturales, el bajo consumo de los alimentos fuente en la población argentina y las recomendaciones actuales de limitar la exposición al sol por el cáncer de piel, emerge como necesario contar con alimentos fortificados de consumo masivo, además de la leche


Introduction: Vitamin D deficiency and diabetes are two prevalent situations in all ages, geographic regions and socioeconomic levels. The presence of receptors for 1,25(OH)2D and the existence of the enzyme 1-α-hydroxylase in the beta cell ­which allows the synthesis of the active metabolite­ suggest that vitamin D plays an important role in these cells and that vitamin deficiency could be a factor that can accelerate the onset and progression of the disease. Objectives: The subject vitamin D and Diabetes was review. The role of vitamin D in insulin resistance and DM2, as well as autoimmunity and DM1, were analyze. We also evaluated the effects of vitamin D supplementation on prevention, glycemic control and evolution of associated complications. Materials and methods: A bibliographic search was carried out using the search engines PubMed, MEDLINE, Cochrane, Research Gate. The search criteria were "vitamin D", "vitamin D and diabetes", "vitamin D and supplementation". Conclusions: There is sufficient evidence that blood levels of 25(OH)D should reach values between 30 and 50 ng/ml to influence metabolic functions. The importance of including 25(OH)D dosage in routine clinical control is emphasized. Taking into account the scarce distribution of vitamin D in natural foods, the low consumption of source foods in the Argentine population and the current recommendations to limit sun exposure due to skin cancer, it emerges as necessary to have fortified foods for mass consumption, in addition to milk


Subject(s)
Vitamin D Deficiency , Diabetes Mellitus , Vitamin D
5.
Rev. chil. obstet. ginecol. (En línea) ; Rev. chil. obstet. ginecol;88(4): 228-236, ago. 2023. tab
Article in English | LILACS | ID: biblio-1515214

ABSTRACT

Insufficient vitamin D levels occur in 88.1% of the worlds population, which constitutes a global public health problem. We analyzed vitamin D deficiency and suggested vitamin D supplementation in the perinatal health of pregnant women living in geographical areas higher than 40° south-north latitude according to reviews from the last three decades and identifying midwives role. The methodology used was a qualitative systematic review of full text studies, conducted in geographical areas higher than 40°N and 40°S. Descriptors such as: "deficiency", "vitamin D", "pregnancy", "causes", "perinatal outcomes" and "supplementation", and their respective descriptors in Spanish. The matrices were tabulated according to the modified PRISMA. Eight studies were obtained in English from the Northern Hemisphere only, mostly with good quality evidence and related to the role of midwifing according to the expert round. The results showed risks such as: origin of the pregnant woman, ethnicity, low sun exposure, obesity, socioeconomic status, and perinatal risks. No studies were found in pregnant women from the Southern Hemisphere or related to the role of the midwife in this area. In conclusion, midwifery should considerer the social determinants of vitamin D deficiency in pregnant women, especially those in extreme southern areas where incorporation of supplementation are suggested as a public policy.


Los niveles insuficientes de vitamina D se dan en el 88,1% de la población mundial, lo que constituye un problema de salud pública global. Se analizó la deficiencia y la sugerencia de suplementación de vitamina D en la salud perinatal de las gestantes residentes en áreas geográficas de latitud 40° sur-norte según revisiones de las últimas tres décadas identificando el rol de la matrona. La metodología utilizada fue una revisión sistemática cualitativa de estudios a texto completo, realizados en áreas geográficas mayores al paralelo 40°N y 40°S. Descriptores como: "deficiencia", "vitamina D", "embarazo", "causas", "resultados perinatales" y "suplementación", y sus respectivos descriptores en español. Las matrices se tabularon según el PRISMA modificado. Se obtuvo ocho estudios en inglés pertenecientes sólo al hemisferio norte, la mayoría con buena calidad de evidencia. Los resultados arrojaron factores como origen de la embarazada, etnia, baja exposición al sol, obesidad, nivel socioeconómico y riesgos perinatales. No se encontraron estudios en mujeres embarazadas del hemisferio sur o relacionados con el papel de la matrona. En conclusión, desde el ejercicio de la matronería se deben considerar los determinantes sociales de las mujeres embarazadas especialmente de zonas extremas del sur donde se sugiere investigación experimental e incorporación de la suplementación como política pública.


Subject(s)
Humans , Female , Pregnancy , Vitamin D/administration & dosage , Vitamin D Deficiency/prevention & control , Midwifery , Risk Factors , Perinatal Care , Extreme Weather
6.
An Pediatr (Engl Ed) ; 98(4): 257-266, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36932016

ABSTRACT

OBJECTIVES: Based on the European and American Cystic Fibrosis (CF) consensus recommendations, an increase in vitamin D (VD) supplementation in patients with CF and insufficient or defficient levels was proposed. The objective of our study was to determine the safety and efficacy of this new protocol. MATERIAL AND METHODS: Multicentre nonrandomized uncontrolled experimental study. Patients with insufficient levels (<30 ng/mL) received increasing doses of VD (between 800 and 10 000 IU/day). Patients were followed up for 12 months, during which their vitamin and nutritional status, pulmonary function and calcium and phosphate metabolism were assessed. STATISTICAL ANALYSIS: t test for paired data and multivariate logistic regression analysis. RESULTS: Thirty patients aged 1-39 years (median, 9.1) completed the follow-up. Two patients were dropped from the study on account of 25-OH VD levels greater than 100 ng/mL at 3 months without clinical or laboratory signs of hypercalcaemia. At 12 months, we observed an increase of 7.6 ng/mL (95% CI, 4.6-10 ng/mL) in the mean 25-OH VD level and an improvement in vitamin status: 37% achieved levels of 30 ng/mL or greater, 50% levels between 20 and 30 ng/mL and 13% remained with levels of less than 20 ng/mL. We found no association between improved VD levels and pulmonary function. CONCLUSIONS: The proposed protocol achieved an increase in serum VD levels and a decrease in the percentage of patients with VD insufficiency, although it was still far from reaching the percentages of sufficiency recommended for this entity.


Subject(s)
Cystic Fibrosis , Vitamin D Deficiency , Humans , Vitamin D/therapeutic use , Cystic Fibrosis/complications , Cystic Fibrosis/drug therapy , Dietary Supplements , Vitamin D Deficiency/drug therapy , Vitamins/therapeutic use
7.
Nutr Hosp ; 40(2): 428-435, 2023 Apr 20.
Article in Spanish | MEDLINE | ID: mdl-36926938

ABSTRACT

Introduction: Background: hypovitaminosis D is frequent in kidney transplant recipient (KTR) patients and is associated with deleterious effects both at the bone and extraosseous levels. Treatment with cholecalciferol is effective for the normalization of 25(OH)D, demonstrating a beneficial effect on the calcium-tropic axis in other populations; however, its effect on the PTH/vitamin D/calcium and FGF23/klotho/phosphorus axis in RTR has not been reported. The aim of this study was to evaluate the effect of normalization of serum 25(OH)D concentrations on the PTH/vitamin D/calcium-FGF23/klotho/phosphorus axis in KTR treated with cholecalciferol, as well as the association between the components of this axis. Methods: a prospective study in 23 KTR with hypovitaminosis D, with evolution from 1 to 12 months post-transplantation, an estimated glomerular filtration rate > 60 mL/min/1.73 m2 and a history of primary nephropathy treated with cholecalciferol, in whom the PTH/vitamin D/calcium and FGF23/klotho/phosphorus axis was evaluated during the state of hypovitaminosis D and at normalization of 25(OH)D. Results: at the normalization of 25(OH)D, a reduction in PTH [103 (58.5-123.9) vs 45.6 (30.1-65.1) pg/mL; p = 0.002] and an increase in serum phosphorus [3.1 (2.3-3.5) vs 3.3 (3-3.6) mg/dL; p = 0.01] were evident, with no differences in calcium, klotho and FGF23 concentrations. The time to achieve normalization of 25(OH)D was 12 weeks (RIC, 4-12), with a dose of 5000 IU/day (RIC, 4000-6000). A positive association between klotho and PTH was corroborated (r = 0.54; p = 0.008; linear regression, ß = 0.421; B = 0.004; 95 % CI, 0.003-0.007; p = 0.045). Conclusions: treatment with cholecalciferol is effective for the normalization of 25(OH)D, with a beneficial effect on calcium-phosphotropic metabolism characterized by a reduction in PTH concentration, without significant changes in calcemia or calciuria, as well as an increase in phosphatemia, without modifications in FGF23 or klotho concentrations.


Introducción: Introducción: la hipovitaminosis D es frecuente en los receptores de trasplante renal (RTR) y se asocia con efectos deletéreos tanto a nivel óseo como extraóseo. El tratamiento con colecalciferol es eficaz para la normalización de la 25(OH)D, demostrándose un efecto benéfico sobre el eje calciotrópico; sin embargo, su efecto sobre el eje fosfotrópico no se ha reportado. El objetivo de este estudio fue evaluar el efecto de la normalización de las concentraciones séricas de 25(OH)D sobre el eje PTH/vitamina D/calcio-FGF23/klotho/fósforo en RTR tratados con colecalciferol, así como la asociación entre sus componentes. Métodos: estudio prospectivo en 23 RTR con hipovitaminosis D y antecedente de nefropatía primaria tratados con colecalciferol, en quienes se evaluó el eje PTH/vitamina D/calcio y FGF23/klotho/fósforo durante el estado de hipovitaminosis D y a la normalización de la 25(OH)D. Resultados: a la normalización de la 25(OH)D se evidenció una reducción de la PTH [103 (58,5-123,9) vs. 45,6 (30,1-65,1) pg/mL; p = 0,002] y un aumento del fósforo sérico [3,1 (2,3-3,5) vs. 3,3 (3-3,6) mg/dL; p = 0,01], sin diferencias en las concentraciones de calcio, klotho y FGF23. El tiempo para lograr la normalización de la 25(OH)D fue de 12 semanas (4-12), con una dosis de 5000 UI/día (4000-6000). Se corroboró una asociación positiva entre klotho y PTH (r = 0,54; p = 0,008; regresión lineal, ß = 0,421; IC 95 %: 0,003-0,007; p = 0,045). Conclusiones: el tratamiento con colecalciferol es eficaz para la normalización de la 25(OH)D con un efecto benéfico sobre el metabolismo calcio-fosfotrópico caracterizado por una reducción de la PTH y un incremento de la fosfatemia, sin modificaciones de calcemia, calciuria, FGF23 o klotho.


Subject(s)
Kidney Transplantation , Vitamin D Deficiency , Humans , Vitamin D , Calcium , Prospective Studies , Parathyroid Hormone , Vitamins , Cholecalciferol/therapeutic use , Phosphorus , Vitamin D Deficiency/drug therapy
8.
Ginecol. obstet. Méx ; Ginecol. obstet. Méx;91(10): 736-752, ene. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1557819

ABSTRACT

Resumen ANTECEDENTES: Existe interés creciente en los efectos de la vitamina D en el embarazo y en la función placentaria, homeostasis de la glucosa, infección y respuesta inflamatoria, además de la asociación de su deficiencia con enfermedades de alto riesgo obstétrico. OBJETIVO: Identificar los aspectos relevantes conocidos y controvertidos del déficit de vitamina D y de su suplementación en pacientes con alto riesgo obstétrico que permitan aportarle al lector herramientas para la toma de decisiones en la práctica clínica. METODOLOGÍA: Se llevó a cabo una revisión de la bibliografía registrada en las bases de datos de MEDLINE vía PubMed, EBSCO y OVID del 2016 al 2022. Se consultaron artículos publicados en inglés y español, con los términos MeSH "Vitamin D", "preeclampsia", "premature birth", "diabestes, gestational" y "fetal growth retardation". RESULTADOS: La búsqueda inicial arrojó 685 artículos de los que se descartaron 364 por falta de pertinencia, 248 por falta del recurso completo y 44 por duplicaciones. De acuerdo con el objetivo planteado, al final quedaron 29 artículos que se complementaron con 55 textos clásicos encontrados en una búsqueda manual para contextualización de la revisión. CONCLUSIONES: La evidencia respecto de la asociación entre deficiencia de vitamina D y pobres desenlaces obstétricos, en términos de tasas de preeclampsia, parto pretérmino, diabetes gestacional y restricción del crecimiento fetal no es concluyente. Sin embargo, el análisis de los estudios mencionados muestra una relación entre el déficit de vitamina D y el aumento del riesgo, desenlaces impactantes y consistentes con el riesgo de resultar con diabetes gestacional.


Abstract BACKGROUND: There is increasing interest in the effects of vitamin D in pregnancy and on placental function, glucose homeostasis, infection and inflammatory response, and the association of vitamin D deficiency with high-risk obstetric conditions. OBJECTIVE: To identify the relevant known and controversial aspects of vitamin D deficiency and its supplementation in patients at high obstetric risk, in order to provide the reader with decision-making tools for clinical practice. METHODOLOGY: A review of the literature registered in the MEDLINE databases via PubMed, EBSCO and OVID from 2016 to 2022 was performed. Articles published in English and Spanish were included using the MeSH terms "vitamin D", "pre-eclampsia", "preterm birth", "gestational diabetes" and "fetal growth retardation". RESULTS: The initial search yielded 685 articles, of which 364 were discarded for lack of relevance, 248 for lack of complete source and 44 for duplication. In accordance with the stated objective, 29 articles remained at the end, which were supplemented by 55 classic texts found in a manual search to contextualise the review. CONCLUSIONS: The evidence for an association between vitamin D deficiency and poor obstetric outcomes in terms of rates of pre-eclampsia, preterm birth, gestational diabetes and fetal growth restriction is inconclusive. However, analysis of the above studies shows an association between vitamin D deficiency and increased risk, with striking results consistent with the risk of gestational diabetes.

9.
Ginecol. obstet. Méx ; Ginecol. obstet. Méx;91(12): 878-884, ene. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1557841

ABSTRACT

Resumen OBJETIVO: Determinar las concentraciones de 25(OH)D en ginecoobstetras y otros especialistas latinoamericanos y conocer la prevalencia de su deficiencia. MATERIALES Y MÉTODOS: Estudio transversal y observacional efectuado para determinar las concentraciones de 25(OH)D en médicos voluntarios, sobre todo ginecoobstetras, que acudieron a diferentes congresos en distintos países latinoamericanos. RESULTADOS: Se analizaron 643 determinaciones. El 19.4% tenían déficit (media 16.58 ng/mL), 72% insuficiencia (media 24.6 ng/mL) y 36.9% concentraciones normales (media 40.34 ng/mL). Los hombres tuvieron mayor déficit-insuficiencia (62.8%) que las mujeres (59.5%), pero sin diferencias significativas (p < 0.058). Las personas de piel clara tuvieron concentraciones deficitarias e insuficientes, menores que las de piel oscura (p < 0.001). Quienes tomaban suplementos de vitamina D tuvieron menor riesgo de déficit. CONCLUSIONES: El 60% de los ginecoobstetras, médicos internistas y generales de Latinoamérica tienen bajas concentraciones de 25(OH)D. La piel clara puede ser un factor de riesgo de mayor déficit-insuficiencia. En los grupos de médicos estudiados la suplementación con vitamina D parece incrementar las concentraciones de 25(OH)D.


OBJECTIVE: To determine 25(OH)D concentrations in obstetrician-gynecologists and other Latin American specialists and to know the prevalence of its deficiency. MATERIALS AND METHODS: Cross-sectional and observational study to determine 25(OH)D concentrations in volunteer physicians, mainly gynecologists, attending different congresses in different Latin American countries. RESULTS: A total of 643 determinations were analysed. 19.4% had deficiency (mean 16.58 ng/mL), 72% insufficiency (mean 24.6 ng/mL), and 36.9% normal concentrations (mean 40.34 ng/mL). Men had higher deficiency-insufficiency (62.8%) than women (59.5%), but no significant differences (p < 0.058). Light-skinned people had lower insufficiency levels than darker-skinned people (p < 0.001). Those taking vitamin D supplements had a lower risk of deficiency. CONCLUSIONS: Sixty percent of obstetrician-gynecologists, internists, and general practitioners in Latin America have low 25(OH)D concentrations. Caucasian skin may be a risk factor for increased deficiency. Vitamin D supplementation appears to improve 25(OH)D concentrations in the physician groups studied.

10.
An. venez. nutr ; 36(1): 3-9, 2023. ilus, tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1556315

ABSTRACT

Introducción. Un estilo de vida poco saludable (malos hábitos alimentarios y sedentarismo), deficiencia de vitamina D, y la ingesta inadecuada de calcio, pueden contribuir a desarrollar osteopenia grave en la infancia, condicionando el riesgo futuro a sufrir fracturas y osteoporosis. Materiales y métodos. Presentamos un caso de osteopenia en una niña blanca, hispana y premenárquica de 13 años quien completó la visita basal del estudio de MetA-Bone. Evaluamos el contenido de masa ósea, la densidad de masa ósea corporal total y de la columna y la composición corporal mediante densitometría ósea (DXA). Abarcamos el historial de salud, antecedentes familiares, desarrollo puberal, actividad física, sueño, ingesta de nutrientes, antropometría, biomarcadores óseos y metabólicos. Resultados. La niña tiene antecedentes familiares de osteoporosis y no reporta fracturas previas. Muestra una actividad moderada al aire libre <1 hora/día 3 veces/semana con 8 horas/día de sueño. El consumo de productos lácteos y vegetales fue <1 ración/día. Presenta deficiencia de vitamina D (25(OH)D: 9 ng/mL) e hiperfosfatemia (5,2 mg/dL). El Z-score del DXA fue -2,1 DE (indicativo de osteopenia por edad y sexo). La niña fue referida a un pediatra, quien confirmó los hallazgos e indicó un suplemento diario con 2000 UI de vitamina D y 1000 mg de calcio. Conclusiones. El aislamiento durante la pandemia de COVID pudo haber contribuido a la gravedad de los hallazgos. Por lo tanto, recomendamos realizar pruebas de detección de vitamina D, calcio y hábitos de vida a los niños que experimentaron crecimiento acelerado durante y después de la pandemia(AU)


Introduction. Poor lifestyle habits, vitamin D deficiency, and inadequate calcium intake, particularly during the COVID-19 pandemic, may contribute to severe osteopenia in childhood, increasing future fractures and osteoporosis risk. Materials and methodology. We here present a case of osteopenia in a 13-year-old white, Hispanic, premenarchal girl who completed the baseline visit of the MetA-Bone Trial during the COVID-19 pandemic. Using a dual-energy X-ray absorptiometry, we assessed bone mass content (BMC), total body and spine bone mass density (BMD), and body composition. We cover the girl's health history and family history, pubertal development, intensity, duration, and frequency of physical activity and sleep, and nutrient intake (calcium and vitamin D), as well as anthropometric parameters, and bone and metabolic biomarkers. Results. The girl has a family history of osteoporosis (maternal grandfather) but no previous fractures; moderate outdoor activity was <1 hour/day 3 times/week with 8 hours/day of sleep. Consumption of dairy products and vegetables was <1 serving/day. Lab blood tests confirmed vitamin D deficiency (serum 25(OH) D: 9 ng/ml) and hyperphosphatemia (5.2 mg/dL); other tests were normal. DXA scan Z-score was -2.1 SD (indicative of osteopenia by age and sex). The girl was referred to a pediatrician, who confirmed the results, and prescribed a daily supplement with 2000 IU of vitamin D and 1000 mg of calcium. Conclusions. Seclusion during the COVID pandemic may have contributed to the severity of the findings. Therefore, we recommend screening children undergoing growth spurts for vitamin D, calcium, and poor lifestyle habits during and after the pandemic(AU)


Subject(s)
Humans , Female , Adolescent , Bone Diseases, Metabolic , Adolescent , Biomarkers
11.
Rev. colomb. med. fis. rehabil. (En línea) ; 33(2): 117-130, 2023. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1531891

ABSTRACT

Introducción. La artritis reumatoidea es una enfermedad autoinmune con un proceso inflamatorio crónico de las articulaciones y con una respuesta catabólica incrementada que predispone a una elevada pérdida de la masa muscular. Objetivo. Evaluar la efectividad de un programa de ejercicios de resistencia más suplementación con vitamina D3 en la movilidad, la masa y la fuerza muscular de pacientes con artritis reumatoidea que acuden a la consulta de medicina física y rehabilitación. Métodos. Ensayo clínico controlado y aleatorizado realizado en 30 pacientes distribuidos equitativamente en tres grupos: grupo control, grupo con ejercicios durante 10 semanas y un grupo con ejercicios durante 10 semanas más suplementación con 2.000 UI de vitamina D3. Las variables fueron evaluadas al inicio del estudio y a las 10 semanas de iniciada la intervención. Resultados. La edad media de los participantes fue 57,73 años y la gran mayoría (93.3%) eran mujeres. En el primer ítem de la evaluación de la escala SPPB (test de equilibrio) se observó un promedio inicial de 3,5 y final de 3,7, en el segundo ítem (test de velocidad de marcha) el promedio inicial fue de 2,8 y el final, de 3,3, y en el tercer ítem (test de levantarse de la silla) el promedio inicial fue de 1,1 y el final, de 1,6, con un resultado significativo final entre ellos (p<0,001). La medición de la masa mediante ultrasonido evidenció un valor significativo en el grupo de ejercicios más suplementación con vitamina D3. Conclusión. La intervención durante 10 semanas de ejercicios de fuerza más suplementación con vitamina D3 (2.000 UI) produce una mejoría sobre los ítems de la escala SPPB y sobre la masa muscular de los músculos bíceps braquial y recto anterior femoral, lo cual podría incidir sobre la disminución del riesgo de caídas en pacientes con artritis reumatoidea.


Introduction. Rheumatoid arthritis is an autoimmune disease with a chronic inflammatory process of the joints and an increased catabolic response that predisposes to a high loss of muscle mass. Objective. To evaluate the effectiveness of a resistance exercise program plus supplementation with vitamin D3 on the mobility, and the muscle mass and strength of patients with rheumatoid arthritis who attend the consultation of physical medicine and rehabilitation. Methods. Randomized controlled clinical trial conducted in 30 patients equitably distributed into three groups: control group, group with exercises for 10 weeks and a group with exercises for 10 weeks plus supplementation with 2,000 IU of vitamin D3. The variables were evaluated at the beginning of the study and 10 weeks after the start of the intervention. Results. The mean age of the participants was 57.73 years and the vast majority of them (93.3%) were women. In the first item of the evaluation in the SPPB scale (balance test) an initial average of 3.5 and a final average of 3.7 was observed, in the second item (gait speed test) the initial average was 2.8 and the second was 3.3, and in the third item (standing up from a chair) the initial average was 1.1, and the final was 1.6, with a significant final result between them (p<0.001). The measurement of the mass using ultrasound evidenced a significant value in the group of exercises plus supplementation with vitamin D3. Conclusion. The intervention during 10 weeks of strength exercises plus supplementation with vitamin D3 (2,000 IU) produces an improvement in the items of the SPPB scale and in the muscle mass of the biceps brachii and rectus femoris, which might have an impact on the reduction of the risk of falls in patients with rheumatoid arthritis.


Subject(s)
Humans , Female , Middle Aged , Vitamin D3 24-Hydroxylase
12.
Arq. ciências saúde UNIPAR ; 27(9): 5401-5422, 2023.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1510774

ABSTRACT

A vitamina D está envolvida em diversos processos fisiológicos dentre homeostase óssea e o sistema imunológico. Pesquisas recentes têm discutido os múltiplos efeitos da vitamina D também como anti-inflamatória e antiviral em várias doenças infecciosas, como a COVID-19. A busca por recursos terapêuticos adjacentes capazes de prevenir e/ou tratar a COVID-19 tem estimulado estudos acerca do papel da vitamina D na infecção por SARS-CoV-2. Neste presente trabalho, os papéis imunomoduladores, antivirais e anti-inflamatórios da vitamina D requerem uma investigação completa, particularmente na perspectiva da COVID-19. Objetivo: Esta revisão tem por objetivo selecionar e sintetizar as evidências atuais da literatura sobre a suplementação da vitamina D em pacientes diagnosticados com COVID-19. Metodologia: Este trabalho foi conduzido de acordo com as diretrizes do protocolo PRISMA. No total 21 artigos selecionados atenderam aos critérios de inclusão e exclusão estabelecidos. Para esta revisão, pesquisamos os bancos de dados PubMed, Embase e BVS (Biblioteca Virtual de Saúde). Estudamos vários estudos observacionais e ensaios clínicos randomizados avaliando o papel da vitamina D na COVID-19 e outras infecções virais contagiosas. Também revisamos as evidências circunstanciais e anedóticas que conectam a vitamina D a COVID-19 que surgiram recentemente. Resultados: A maioria dos estudos mostram associação entre baixos níveis séricos de vitamina D e o aumento da gravidade e da mortalidade da COVID-19. Apenas 4 estudos não demonstraram haver associação entre os níveis basais de calcidiol e o desfecho da COVID-19. Conclusão: Embora as evidências disponíveis até o momento apontem possível efeito protetor da vitamina D nas internações em UTI relacionadas a doença causada por Sars CoV-2, ainda são necessários estudos clínicos controlados bem desenhados para validar a dose e a eficácia da suplementação de vitamina D na COVID-19 e em outras infecções virais.


Vitamin D is involved in several physiological processes including bone homeostasis and the immune system. Recent research has discussed the multiple effects of vitamin D also as anti-inflammatory and antiviral in various infectious diseases such as COVID-19. The search for adjacent therapeutic resources capable of preventing and/or treating COVID-19 has stimulated studies about the role of vitamin D in SARS-CoV-2 infection. In this work, the immunomodulatory, antiviral and anti-inflammatory roles of vitamin D require thorough investigation, particularly from the perspective of COVID-19. Objective: This review aims to select and synthesize current literature evidence on vitamin D supplementation in patients diagnosed with COVID-19. Methodology: This work was conducted according to the guidelines of the PRISMA protocol. A total of 21 articles selected met the established inclusion and exclusion criteria. For this review, we searched the PubMed, Embase and VHL (Virtual Health Library) databases. We studied several observational studies and randomized clinical trials evaluating the role of vitamin D in COVID-19 and other contagious viral infections. We also reviewed the circumstantial and anecdotal evidence connecting vitamin D to COVID-19 that has recently emerged. Results: Most studies show association between low serum vitamin D levels and increased COVID-19 severity and mortality. Only 4 studies showed no association between baseline calcidiol levels and COVID-19 outcome. Conclusion: Although the evidence available so far points to a possible protective effect of vitamin D in ICUs related to Sars CoV-2 disease, well-designed controlled clinical studies are still needed to validate the dose and efficacy of vitamin D supplementation in COVID-19 and other viral infections.


La vitamina D participa en varios procesos fisiológicos entre la homeostasis ósea y el sistema inmunitario. En investigaciones recientes se han examinado también los múltiples efectos de la vitamina D como agente antiinflamatorio y antirviral en diversas enfermedades infecciosas, como la COVID-19. La búsqueda de recursos terapéuticos adyacentes capaces de prevenir y/o tratar el COVID-19 ha estimulado estudios sobre el papel de la vitamina D en la infección por el SARS-CoV-2. En este trabajo, los roles inmunomoduladores, antivirales y antiinflamatorios de la vitamina D requieren una investigación completa, particularmente desde la perspectiva de la COVID-19. Objetivo: Esta revisión tiene por objeto seleccionar y resumir las pruebas actuales de la bibliografía sobre la suplementación con vitamina D en pacientes diagnosticados con COVID-19. Metodología: Este trabajo se ha realizado de conformidad con las directrices del protocolo PRISMA. En total, 21 artículos seleccionados cumplían los criterios de inclusión y exclusión establecidos. Para esta revisión, revisamos las bases de datos PubMed, Embase y Virtual Health Library (BVS). Se estudiaron diversos estudios observacionales y ensayos clínicos aleatorios en los que se evaluó el papel de la vitamina D en el COVID- 19 y otras infecciones víricas contagiosas. También revisamos la evidencia circunstancial y anecdótica que conecta la vitamina D con la COVID-19 que ha surgido recientemente. Resultados: La mayoría de los estudios muestran asociación entre niveles bajos de vitamina D sérica y aumento de la severidad y mortalidad de COVID-19. Sólo 4 estudios no demostraron una combinación de los niveles basales de calcilo y los resultados de COVID-19. Conclusión: Aunque la evidencia disponible hasta el momento indica un posible efecto protector de la vitamina D en las internaciones de la UIT relacionadas con la enfermedad de Sars CoV-2, todavía se requieren estudios clínicos controlados y bien diseñados para validar la dosis y eficacia de los suplementos de vitamina D en COVID- 19 y otras infecciones virales.

13.
Rev. chil. ortop. traumatol ; 63(3): 178-183, dic.2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1437118

ABSTRACT

OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.


OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tibial Fractures/drug therapy , Vitamin D Deficiency/epidemiology , Cholecalciferol/therapeutic use , Calcium-Regulating Hormones and Agents , Chile/epidemiology , Incidence , Prevalence
14.
ARS med. (Santiago, En línea) ; 47(4): 19-24, dic. 26, 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1451536

ABSTRACT

Introducción: la citología permite examinar células de un tejido de manera mínimamente invasiva, sin embargo, la capacidad de realizar técnicas complementarias como la inmunocitoquímica (ICQ) no está exenta de dificultades. Es el objetivo de nuestro trabajo presentar una metodología que permita la utilización de ICQ automatizada asociada a un análisis automatizado mediante técnica de patología digital. Métodos: se incluyeron 5 sujetos sanos y se obtuvieron muestras de superficie ocular utilizando un citocepillo. La muestra fue procesada de manera automatizada mediante citología en fase líquida. Posteriormente se realizó ICQ automatizada para detectar la positividad nuclear del receptor de vitamina D. Para la evaluación, se utilizaron dos métodos: cuantificación directa bajo microscopio de luz y análisis automatizado usando analizador de imágenes en las diapositivas digitales obtenidas con un Scanner. El porcentaje de positividad encontrado con ambos métodos fueron comparados utilizando la prueba de Kappa. Resultados: todas las muestras presentaron una celularidad adecuada. En todos los casos fue posible realizar ICQ automatizada, más aún, todas las muestras presentaron una calidad óptima. Al comparar ambos métodos (manual versus automatizado) se observó un nivel de acuerdo sustancial (Kappa=0,69). Conclusiones: la metodología presentada en este manuscrito permite la evaluación automatizada de marcadores inmunohistoquímicos de la superficie ocular de manera mínimamente invasiva, siendo similar al conteo manual, pero más objetivo y reproducible. Esta técnica podría ser útil para el estudio proteómico en patologías como la enfermedad por ojo seco.


Introduction: Cytology tests use small amounts of tissue samples for diagnosis as a minimally invasive technique; however, the ability to perform complementary methods such as immunocytochemistry (ICC) is not without difficulties. The aim of our work is to present a method that allows the use of automated ICC associated with an automated image analysis using digital pathology. Methods: Five healthy subjects were included, and ocular surface samples were obtained using a cytobrush. The sample was processed as liquid-based cytology. Automated ICC was subsequently performed to detect vitamin D receptor nuclear positivity. Two methods were used for evaluation: manual counting under a light microscope and automated analysis using an image analyzer on digitized slides. The percentage of positivity found in both methods was compared using the Kappa test. Results: All samples presented adequate cellularity. In all cases, it was possible to perform automated ICC; moreover, all samples presented optimal quality. When comparing both methods (manual versus automated), a substantial level of agreement was seen (Kappa=0.69). Conclusions. The method presented in this manuscript allows the minimally invasive automated evaluation of ocular surface ICC markers, being like manual counting but more objective and reproducible. This technique could be useful for proteomic study in pathologies such as dry eye disease.

15.
Nutr Hosp ; 39(6): 1397-1407, 2022 Dec 20.
Article in Spanish | MEDLINE | ID: mdl-36327123

ABSTRACT

Introduction: Previous studies have pointed to a possible relationship between vitamin D deficiency and the severity of the disease promoted by SARS-CoV-2, reducing respiratory and cardiovascular complications caused by a hyperreaction of the immune system known as "cytokine storm". This vitamin exerts multiple functions that depend on the presence and levels of different proteins, such as the vitamin D receptor (VDR) and the vitamin D binding protein (DBP), and the existence of single nucleotide polymorphisms (SNPs) of the genes that encode these proteins. The objective of this review is to assess whether some VDR and GC SNPs are risk factors for the most severe forms of COVID-19 disease and whether they condition the response to vitamin D supplementation. A search was performed in PubMed, Google Scholar and Scielo, finding that genotypes in patients affected by COVID-19, were rarely performed, although some studies find a relationship between different alleles and the severity of the disease. The ApaI polymorphism of the VDR gene stands out, as the minor allele "a" increases the risk of mortality from COVID-19 (OR = 11.828, CI: 2,493-56,104, p = 0.002). Results divergency in the efficacy of vitamin D supplementation suggest the need for a larger number of studies. In conclusion, the study of VDR and GC polymorphisms seems essential to effectively treat vitamin D deficiency and particularly to protect against COVID-19. Well-designed studies are needed to elucidate whether plasma vitamin D levels play a role of casuality or causality.


Introducción: Estudios previos han señalado una posible relación entre la deficiencia de la vitamina D y la severidad de la enfermedad promovida por el SARS-CoV-2, reduciendo las complicaciones respiratorias y cardiovasculares causadas por una respuesta exacerbada del sistema inmune. Esta vitamina ejerce múltiples funciones que dependen de la presencia y niveles de diferentes proteínas, como el receptor de la vitamina D (VDR) y la proteína de unión de la vitamina D (DBP), y de la existencia de polimorfismos de un solo nucleótido (SNP) de los genes que codifican a estas proteínas. El objetivo de esta revisión es evaluar si algunos SNP de VDR y GC son factores de riesgo de las formas más severas de la enfermedad COVID-19 y si condicionan la respuesta a la suplementación con vitamina D. Se realizó una búsqueda en PubMed, Google Scholar y Scielo, encontrándose que son escasos los genotipados en pacientes afectados por COVID-19, aunque algunos trabajos hallan una relación entre diferentes alelos y la severidad de la enfermedad. Destaca el polimorfismo ApaI del gen VDR, el cual alelo menor "a" aumenta el riesgo de mortalidad por COVID-19 (OR = 11,828, CI: 2.493-56.104, p = 0,002). La divergencia de resultados en la eficacia de la suplementación de vitamina D sugiere la necesidad de un mayor número de estudios. En conclusión, el estudio de polimorfismos VDR y GC resulta fundamental para tratar eficazmente la deficiencia de vitamina D y en particular en la protección frente a COVID-19. Se necesitan estudios bien diseñados para dilucidar si los niveles plasmáticos de vitamina D juegan un papel de casualidad o causalidad.


Subject(s)
COVID-19 , Receptors, Calcitriol , SARS-CoV-2 , Vitamin D Deficiency , Vitamin D-Binding Protein , Vitamin D , Humans , COVID-19/complications , COVID-19/mortality , Genotype , Polymorphism, Single Nucleotide , Receptors, Calcitriol/genetics , Vitamin D/metabolism , Vitamin D Deficiency/complications , Vitamin D Deficiency/genetics , Vitamin D-Binding Protein/genetics
16.
Schweiz Arch Tierheilkd ; 164(9): 625-633, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36047818

ABSTRACT

INTRODUCTION: Colostrum contains higher amounts of vitamins D3 and E than mature milk. Due to the structural feature of the goat placenta, goat kids are born with very low reserves of fat-soluble vitamins and must rely on colostrum to acquire adequate plasma levels of vitamin D3 and vitamin E. In the present study, vitamin E was measured in the form of α-tocopherol which is the most dominant isoform present in milk samples. The main aim of the present study is to determine the colostrum vitamin D3 and E content in Honamli and hair goats in the early postpartum stage by high-performance liquid chromatography. Five Honamli and five hair goat colostrum samples were collected on the day of kidding and on the third and fifth days postpartum. On the sampled days, the colostrum of both goat breeds contains higher concentrations of vitamin D3 and α-tocopherol than that in mature milk (p< 0,05) and there was the existence of a breed difference in colostrum vitamin D3 and α-tocopherol concentrations (p< 0,05) was determined. Also, the effect of sampling day on colostrum vitamin D3 concentration in samples that were obtained between the first and third days was also significant (p< 0,05). Hair goat colostrum α-tocopherol concentrations were found to be higher than Honamli goats (p< 0,05). Additionally, there was a statistically significant difference between the sampling day and α-tocopherol content on days one and five (p < 0,05).


INTRODUCTION: Le colostrum contient des quantités plus élevées de vitamines D3 et E que le lait. En raison des caractéristiques structurelles du placenta de la chèvre, les chevreaux naissent avec de très faibles réserves de vitamines liposolubles et doivent compter sur le colostrum pour acquérir des niveaux plasmatiques adéquats de vitamine D3 et de vitamine E. Dans la présente étude, la vitamine E a été mesurée sous la forme d'α-tocophérol qui est l'isoforme la plus dominante présente dans les échantillons de lait. L'objectif principal de la présente étude était de déterminer la teneur en vitamines D3 et E du colostrum chez les chèvres Honamli et les chèvres angoras au début du post-partum par chromatographie liquide à haute performance. Cinq échantillons de colostrum de chèvres Honamli et cinq de chèvres angoras ont été collectés le jour de la mise bas et les troisième et cinquième jours du post-partum. Aux jours échantillonnés, le colostrum des deux races de chèvres contenait des concentrations de vitamine D3 et d'α-tocophérol plus élevées que celles du lait (p< 0,05) et l'existence d'une différence entre les races dans les concentrations de vitamine D3 et d'α-tocophérol du colostrum (p< 0,05) a été mesurée. De plus, l'effet du jour d'échantillonnage sur la concentration en vitamine D3 du colostrum dans les échantillons qui ont été obtenus entre le premier et le troisième jour était également significatif (p< 0,05). Les concentrations d'α-tocophérol dans le colostrum des chèvres angoras se sont avérées plus élevées que celles des chèvres Honamli (p< 0,05). En outre, il y avait une différence statistiquement significative entre le jour d'échantillonnage et la teneur en α-tocophérol aux jours un et cinq (p < 0,05).


Subject(s)
Colostrum , Goats , Animals , Cholecalciferol , Colostrum/chemistry , Female , Lactation , Milk/chemistry , Postpartum Period , Pregnancy , Vitamin E/analysis , Vitamins/analysis , alpha-Tocopherol/analysis
17.
Nutr Hosp ; 39(Spec No3): 30-34, 2022 Sep 01.
Article in Spanish | MEDLINE | ID: mdl-36040009

ABSTRACT

Introduction: Vitamin D is a key nutrient for health. Recent research has shown that it is not only necessary for the maintenance of bone health, but also for the prevention of cardiovascular diseases, insulin resistance, respiratory diseases, infections, and cancer, among others. Solar synthesis of vitamin D is usually insufficient, so it is necessary to provide enough vitamin D through the diet in order to maintain an adequate nutritional status. Studies carried out in Spain and other countries have shown that serum levels of the vitamin were usually insufficient and that average dietary intakes were well below those marked as recommended, while the main food sources of vitamin D were fatty fish, breakfast cereals, eggs, and dairy. Food sources of vitamin D are scarce, and it is naturally located in the fatty part of foods of animal origin, and in the liver and viscera. Fortifying foods that are not natural food sources of vitamin D but are regularly consumed by a significant percentage of the population, is a strategy that could help to increase vitamin D intake. In this regard, dairy products and breakfast cereals are two of the most widely used food matrices for vitamin D fortification, and their incorporation into the usual diet has proven to be an effective strategy to improve the nutritional situation of the population in vitamin D.


Introducción: La vitamina D es clave en la salud y sus funciones se relacionan con el mantenimiento de la salud ósea, cardiovascular, la resistencia a la insulina, enfermedades respiratorias, infecciones y cáncer, entre otras. La síntesis solar de la vitamina D es con frecuencia insuficiente, por lo que para mantener un estatus adecuado de la vitamina es necesario que se aporten cantidades suficientes con la dieta. Los estudios realizados en España y en otros países muestran que los niveles séricos de la vitamina son con frecuencia insuficientes y que las ingestas dietéticas medias se encuentran muy por debajo de las marcadas como recomendadas. Las principales fuentes alimentarias de la vitamina D son los pescados grasos, los cereales de desayuno, los huevos y los lácteos. Las fuentes alimentarias de vitamina D son escasas y se encuentra especialmente en la parte grasa de alimentos de origen animal, en hígados y en vísceras. El enriquecimiento de alimentos que de forma natural no tienen un elevado contenido en vitamina D, pero que son consumidos habitualmente por un porcentaje significativo de la población, es una estrategia que ayuda a aumentar su ingesta. En este sentido, los lácteos y los cereales de desayuno son dos de las matrices alimentarias más utilizadas y su incorporación en la dieta habitual ha demostrado ser una estrategia eficaz para mejorar la situación nutricional de la población respecto a la vitamina D.


Subject(s)
Food, Fortified , Vitamin D , Animals , Diet , Nutritional Status , Vitamins
18.
Clin Investig Arterioscler ; 34(6): 311-321, 2022.
Article in English, Spanish | MEDLINE | ID: mdl-35817704

ABSTRACT

BACKGROUND AND OBJECTIVES: Vitamin D(vitD) participates in phospho-calcium metabolism and exerts multiple pleiotropic effects. There is tissue 1-α (OH)ase that converts 25-OH cholecalciferol (25 (OH) D) in calcitriol that exerts autocrine and paracrine effects. 25 (OH)D deficiency could limit these tissue effects of vitD. The administration of nutritional vitD and the activator of the vitD receptor, paricalcitol, may promote beneficial effects on vascular and renal function. The objective of this work was to study in subjects with chronic kidney disease (CKD) the effect that the administration of different forms of vitD has on arterial function and albuminuria, and the possible relationship between the modifications of these variables. PATIENTS AND METHODS: We studied in 97 patients with CKD stages 3-4 the effect of the administration of cholecalciferol (group 2; n: 35) and paricalcitol (n: 31; group 3) on parameters derived from brachial blood pressure, aortic blood pressure and on aortic stiffness studied using carotid-femoral pulse velocity (Vpc-f), and on albuminuria. A group of patients with stages 3-4 CKD who did not receive vitD therapy served as a control group (n: 31; group 1). All parameters were studied at baseline and after the follow-up period which was 7 ± 2 months. RESULTS: In the baseline phase, no differences were observed between the groups in brachial systolic blood pressure (bSBP), central systolic blood pressure (SBP), brachial pulse pressure (bPP), and central pulse pressure (pCP) or in aortic stiffness that was increased in all groups with a baseline Vpc-f value of 10.5 (9.2-12.1) m/sec. The baseline albuminuria value in the grouped patients was 229 (43-876) mg / g (median (interquartile range)), with no differences between the groups. Serum calcium and phosphorus increased significantly in those treated with cholecal-ciferol (native vitD) and paricalcitol (active vitD). Parathormone (PTH) values decreased in those treated with paricalcitol.bPP and cPP decreased in all groups treated with native and active vitD. No significant changes in bPP and cPP were observed in the control group. Vpc-f did not change significantly in any of the groups, although the variation was quantitatively greater in group 3 (11.2±2 vs. 10.7±1.6 (P=.06)). No differences were observed in the changes in Vpc-f between the groups when adjusted to the baseline values of estimated glomerular filtration rate (eGFR), albuminuria, PTH, vitD, brachial and central blood pressure parameters, and their changes with treatment.Those who received treatment with native and active vitD presented a significant decrease in albuminuria of 17% (group 2) and 21% (group 3) compared to a 16% increase in the untreated group (group 1) (P=.01). A decrease in albuminuria ≥30% was observed more frequently in the groups treated with some form of vitD (group 2: 23%; group 3: 45%) than in the control group (13%) (P=.03). The decrease in albuminuria observed in the groups treated with any of the forms of vitD did not vary when the baseline values of the biochemical parameters of phosphorus-calcium metabolism, those of arterial function (PPb, PPc, Vpc-f) or its modifications were introduced as covariates. There was no significant correlation between changes in Vpc-f and albuminuria. In logistic regression, changes in arterial function parameters were also not explanatory for the ≥30% decrease in albuminuria. CONCLUSIONS: In patients with CKD stages 3-4, treated with RAS blockers and with residual albuminuria, the administration of or paricalcitol reduces brachial and aortic pulse pressures, and albuminuria. The decrease in albuminuria does not seem to be mediated, at least not decisively, by changes in central hemodynamics or aortic stiffness.


Subject(s)
Renal Insufficiency, Chronic , Vascular Stiffness , Humans , Vitamin D/pharmacology , Blood Pressure/physiology , Vascular Stiffness/physiology , Albuminuria/drug therapy , Albuminuria/etiology , Calcium/pharmacology , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/drug therapy , Vitamins/pharmacology , Cholecalciferol/pharmacology , Phosphorus/pharmacology
19.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1385897

ABSTRACT

RESUMEN: Determinar el rol de la vitamina D (VD) en el desarrollo y tratamiento de liquen plano oral (LPO). Se realizó una revisión sistemática exploratoria durante el mes de Abril del 2021 utilizando Pubmed/Medline, Ebsco y Scopus/ Elsevier. Se utilizaron los términos "Oral lichen planus" y "Vitamin D". Se incluyeron sólo estudios en humanos y fueron excluidos aquellos de más de 5 años de antigüedad. Se obtuvieron 40 artículos, de los cuales 15 se descartaron por estar duplicados. Al seleccionar según título y resúmenes, 7 publicaciones cumplían con los criterios para ser incluidas en esta revisión. Diversas investigaciones han cuantificado niveles de VD en pacientes con LPO obteniendo mediciones significativamente más bajas que en pacientes sanos. Además, se describe una posible correlación entre la severidad del cuadro y la magnitud del déficit. Finalmente, la suplementación con VD como coadyuvante surge como alternativa para la disminución de síntomas dado su rol en procesos inmunes y a reportes de mejoras en cuadros de LPO a partir de su uso. Pacientes diagnosticados con LPO tienen niveles insuficientes de VD sérica en comparación con pacientes sanos. La deficiencia del micronutriente se relaciona con una respuesta inflamatoria exagerada y alteraciones del sistema inmune. La suplementación de VD en pacientes con LPO sería beneficiosa como coadyuvante al tratamiento con corticosteroides en casos severos. Sin embargo, la escasa evidencia hace necesario realizar más estudios clínicos que reafirmen la efectividad de la VD como tratamiento complementario de LPO.


ABSTRACT: To determine the role of vitamin D (VD) in the development and treatment of oral lichen planus (OLP). An exploratory systematic review was carried out during April of 2021 using the databases Pubmed / Medline, Ebsco and Scopus / Elsevier. The terms "Oral lichen planus" and "Vitamin D" were used. Only human studies were included and those publications older than 5 years old were excluded. 40 articles were obtained, of which 15 were discarded because they were duplicated. When selecting according to title and abstract, publications met the criteria to be included in this review. Various investigations have quantified VD levels in patients with OLP: obtaining significantly lower measurements than in healthy patients. In addition, a possible correlation between the severity of the condition and the magnitude of the deficit is described. Finally, supplementation with VD as an adjuvant arises as an alternative for the reduction of symptoms, given the role of VD in immune processes and reports of improvements in OLP symptoms with its use. Patients diagnosed with OLP have insufficient levels of serum VD compared to healthy patients. Micronutrient deficiency is related to an exaggerated inflammatory response and alterations in the immune system. VD supplementation in patients with OLP would be beneficial as an adjunct to corticosteroid treatment in severe cases. However, the limited evidence makes it necessary to carry out more clinical studies to reaffirm the effectiveness of VD as a complementary treatment for OLP.

20.
Rev. Bras. Saúde Mater. Infant. (Online) ; 22(2): 199-211, Apr.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1387185

ABSTRACT

Abstract Objectives: to assess the effects of vitamin D supplementation during pregnancy on the outcomes of vitamin D concentration in newborns, length at birth, overall health (Apgar), birth weight and maternal vitamin D concentration after childbirth. Methods: this research was conducted in the electronic databases of MEDLINE, LILACS, EMBASE and Cochrane Library until December 2020, using the terms "vitamin D", "pregnancy", "vitamin D deficiency", "infant", "newborn" and their synonyms. Randomized controlled trials were searched by evaluating the effects of maternal vitamin D supplementation in neonates. The data was analyzed on RevMan 5.4 software and the quality of evidence on GRADE. Results: the newborn's overall health condition was presented as Apgar, with a mean difference (MD) of 0.15 (CI95%=0.06-0.25; p=0.002; I2=0%, two studies, 648 participants, moderate quality evidence) at the first minute and 0.11 (CI95%=0.04-0.17; p=0.001; I2=0%, two studies, 648 participants, moderate quality evidence) at the fifth minute. Significant effects were also presented at the length at birth considering any supplemented dose (MD=0.19; CI95%=0.08-0.30; p=0.0010; I2=0%, 1452 participants, low quality evidence) and birth weight in doses higher than 4000IU/day (MD=257.05 (CI95%=137.81-376.29; p<0.0001; I2=14%, 176 participants, moderate quality evidence). Conclusion: vitamin D supplementation during pregnancy improves serum 25 (OH) D concentration and suggests positive effects on overall health condition, length at birth and birth weight. PROSPERO CRD42017073292.


Resumo Objetivos: avaliar os efeitos da suplementação materna de vitamina D durante a gravidez nos desfechos concentração de vitamina D no recém-nascido, comprimento ao nascer, estado geral de saúde (Apgar), peso ao nascer e concentração de vitamina D materna após o nascimento. Métodos: a pesquisa foi conduzida nas bases de dados eletrônicas MEDLINE, LILACS, EMBASE e Cochrane Library até dezembro de 2020, utilizando os termos "vitamin D", "pregnancy", "vitamin D deficiency", "infant", "newborn" e seus sinônimos. Pesquisou-se por ensaios clínicos randomizados avaliando os efeitos da suplementação materna de vitamina D no neonato. Os dados foram analisados pelo software RevMan 5.4 e a avaliação da qualidade das evidências pelo GRADE. Resultados: o estado geral de saúde do recém-nascido foi apresentado como Apgar, com uma diferença de média (DM) de 0,15 (IC95%=0,06-0,25; p=0,002; I2=0%, dois estudos, 648 participantes, evidência de qualidade moderada) para o teste no primeiro minuto e 0,11 (IC95%=0,04-0,17; p=0,001; I2=0%, dois estudos, 648 participantes, evidência de qualidade moderada) para quinto minuto. Efeitos significativos também foram apresentados para o comprimento ao nascer em qualquer dose suplementada (DM=0,19 (IC95%=0,08-0,30; p=0,0010; I2=0%, 1452 participantes, evidência de baixa qualidade) e peso ao nascer em doses maiores que 4000UI/dia (DM=257,05 (IC95%=137,81-376,29; p<0,0001; I2=14%, 176 participantes, evidência de qualidade moderada). Conclusão: a suplementação de vitamina D durante a gravidez melhora a concentração sérica de 25 (OH)D e sugere apresentar efeitos positivos no estado geral de saúde, comprimento ao nascer e peso ao nascer. PROSPERO CRD42017073292.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Vitamin D/pharmacology , Vitamin D Deficiency/prevention & control , Birth Weight/drug effects , Dietary Supplements , Body Size/drug effects , Cephalometry , Pregnant Women , Maternal Nutrition
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